Location:
Munich, Germany

Context of intervention:
German health insurance companies do not accept to cover undocumented migrants. If they cannot pay for medical treatment themselves, they are only entitled to healthcare when they have acute medical problems - in these cases the social security system will bear the costs. However, the social services are obliged to report people without a residence permit to the public authority responsible for foreigners. Fear of the consequences leads most undocumented migrants to visit the doctor only when they can bear the costs themselves.

Objectives:
Since September 2006, Doctors of the World works in collaboration with Café 104 (an initiative from the Bavarian Council for refugees) to grant uninsured people an access to basic healthcare.

Activities:
Twice a week, Open.med's voluntary doctors provide patients with advice and care. For specific problems like toothaches or pregnancies, patients are referred to a network of 60 partner doctors or healthcare providers capable of taking over.
A psychological help is also provided. Volunteers listen to the patients' problems, assist them, and try to solve their issues with the help of social workers and institutions.
Pregnancies, toothaches and orthopaedic matters represent the biggest part of medical problems. People suffering from AIDS and other heavy diseases are also taken care of. These issues are very often linked to their lives in dire conditions and are worsened by psychological problems. Therefore intensive help and advice are needed. A hotline is also available daily for emergencies.
The close cooperation between Doctors of the World and Café 104 allows Open.med to provide medical, psycho-social and legal advice, as well as medical care, personal assistance and support. Patients receive free treatment from all the medical services and doctors that work with Open.med. When a more expensive clinical treatment is necessary, a specific solution to cover the costs has to be found for each particular case. ärzte der Welt uses its donations to finance necessary treatments which cannot be funded otherwise.
In 2007, 700 consultations were carried out.

Beneficiaries:
In 2007, many patients came from Eastern European countries (41.8%) and Latin America (16.9 %), about 61.8 % were women. Many of our patients were EU-citizens (24.9 %), mainly from the new member states such as Romania, Bulgaria or Poland. Many were undocumented (illegal) migrants or had a very precarious residence permit (28.1 %). A high number (14.8 %) came from Germany but without health insurance. Some others did not know where to go or who to contact in order to receive healthcare. Beside pregnancies, orthopaedic, gynaecological, psychological and dental problems were the main reasons why patients came to Open.med.